Home Drug Guide Triamcinolone Acetonide

Drug Guide

Generic Name

Triamcinolone Acetonide

Brand Names Kenalog, Kenalog-10, Kenalog In Orabase, Kenalog-40, Kenalog-80, Azmacort, Nasacort, Allernaze, Nasacort Allergy 24 Hour, Nasacort Hfa, Triesence, Trivaris, Oralone, Aristocort, Aristocort A, Aristogel, Triacet, Flutex, Kenalog-h, Triacort, Triatex, Triderm, Trymex, Trianex, Zilretta, Xipere

Classification

Therapeutic: Anti-inflammatory, Corticosteroid

Pharmacological: Glucocorticoid receptor agonist

FDA Approved Indications

Inflammatory and allergic conditions affecting the skin, eyes, nasal passages, joints, and other organs
Asthma (nasal spray)
Ocular inflammation (ophthalmic)
Intra-articular corticosteroid for joint conditions
Other inflammatory conditions

Mechanism of Action

Triamcinolone acetonide binds to glucocorticoid receptors, modulating gene expression to exert anti-inflammatory, immunosuppressive, and anti-proliferative effects.

Dosage and Administration

Adult: Dose varies based on formulation and condition. For nasal spray: typically 2 sprays per nostril once daily. For intra-articular injections: dose depends on the joint and severity.

Pediatric: Use varies; nasal spray dose generally 1-2 sprays per nostril daily, adjusted based on age and condition.

Geriatric: Start at lower end of dosing range; monitor for systemic effects.

Renal Impairment: No specific adjustment recommended, but caution advised.

Hepatic Impairment: No specific adjustment; corticosteroid sensitivity may be increased.

Pharmacokinetics

Absorption: Rapid absorption following inhalation and intranasal administration.

Distribution: Wide distribution; binds extensively to plasma proteins.

Metabolism: Hepatic metabolism via CYP3A4 enzyme.

Excretion: Metabolites excreted primarily in urine.

Half Life: Approximately 2-3 hours for plasma; biological effects last longer.

Contraindications

Hypersensitivity to triamcinolone or other corticosteroids.
Viral, bacterial, fungal, or systemic infections, unless adequately treated.

Precautions

Use with caution in immune-compromised patients
Monitor for secondary infections
Avoid live vaccines during therapy

Adverse Reactions - Common

Local burning, itching, dryness (nasal spray) (Common)
Transient headache (nasal spray) (Common)
Skin atrophy (topical) (Common)

Adverse Reactions - Serious

Adrenal suppression (Rare)
Secondary infections (Rare)
Visual disturbances (ocular routes) (Rare)

Drug-Drug Interactions

Potent CYP3A4 inhibitors (e.g., ketoconazole) increase corticosteroid levels.
Other immunosuppressants and K-sparing diuretics may increase risk of systemic effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, blood glucose levels, and corticosteroid side effects.

Diagnoses:

Risk for infection
Impaired skin integrity
Altered immune response

Implementation: Administer as prescribed; educate patient on proper administration.

Evaluation: Assess symptom improvement and monitor for adverse effects.

Patient/Family Teaching

Use medication exactly as prescribed.
Report signs of infection, unusual vision changes, or mood swings.
For nasal sprays, prime device before use.
Do not discontinue abruptly without consulting healthcare provider.

Special Considerations

Black Box Warnings:

Potential for systemic corticosteroid effects, including adrenal suppression.
Use with caution in children due to growth suppression risk.

Genetic Factors: None specific.

Lab Test Interference: May cause falsely elevated glucose levels, interfere with growth hormone tests.

Overdose Management

Signs/Symptoms: Cushingoid features, suppressed adrenal function.

Treatment: Discontinue drug gradually; provide supportive care; in severe cases, administer corticosteroid antagonist or supportive measures.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable for at least 24 months under recommended conditions.